Sweet Expectations

By Allison NimlosHealth & Fitness

Sweet Expectations episodes

November 21, 2024Lessons Learned from Spontaneous Labor & Empowered Births, with Cali Young, T1D mom of 3
In this episode, I interview Callie Young, a mother of three and currently 20 weeks pregnant with her fourth (!) child, who has lived with Type 1 Diabetes since childhood. Callie shares her experiences navigating pregnancy with diabetes, discussing the evolution of her approach over the years, the challenges of insulin resistance, and the importance of self-advocacy in healthcare. Callie has had the rare experience for a high-risk pregnancy of having spontaneous labor with all 3 of her children. Our conversation highlights the important balance between managing diabetes and motherhood, advocating for yourself in medical settings and finding the right fit in a healthcare provider, and the importance of having strong support systems.
Takeaways
Knowledge is power; the more you know, the more confident you become.

Self-advocacy is crucial in healthcare; don't hesitate to ask questions.

Maintaining a routine with meals helps manage blood sugar levels.

Insulin resistance is a real challenge during pregnancy; be prepared to adapt.

Having a support system is vital for managing diabetes and motherhood.

It's important to prioritize self-care; you can't pour from an empty cup.

Be proactive in your healthcare; don't wait for appointments to make changes.

Educate yourself about all birthing options, including spontaneous labor.

Postpartum care is just as important as pregnancy care; prioritize your health.

Every pregnancy is different; learn from each experience to improve future outcomes.

00:00 Introduction to Callie's Journey
10:37 Understanding Insulin Resistance
14:59 Managing Insulin During Pregnancy
23:45 Takeaways for Expecting Mothers
32:03 Navigating Labor and Delivery Choices
38:51 Tools for a Positive Birth Experience
45:21 Postpartum Management and Self-Care

Mentioned:
Register for Advanced Dosing Strategies, this Monday, November 25!

⁠⁠⁠⁠⁠Check us out on Instagram at our NEW IG handle: ⁠⁠⁠⁠@sweetexpectations__⁠⁠⁠⁠

Want to learn all there is about Diabetes & Pregnancy: ⁠⁠⁠Your T1D Pregnancy Roadmap⁠⁠⁠ will get your journey off to the right start.

Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠⁠⁠Apply for 1-on-1 coaching here!⁠⁠
54 min
October 30, 2024Navigating Pregnancy with Diabetes: Expert Insights, with Dr. Sarit Polsky
This week, Dr. Sarit Polsky discusses the complexities of managing diabetes during pregnancy, emphasizing the importance of preconception planning, the role of technology in diabetes management, and the emotional aspects of navigating unexpected pregnancies. We cover essential topics such as A1C management, the impact of menstrual cycles on diabetes, and the benefits of continuous glucose monitoring and automated insulin delivery systems. Dr. Polsky reassures us that with proper planning and support, a healthy pregnancy is achievable for you too!
Takeaways
Planning ahead is crucial for a healthy pregnancy.

Discuss preconception counseling with your endocrinologist.

Continuous glucose monitoring is recommended for type 1 diabetes pregnancies.

Automated insulin delivery systems can help manage diabetes in pregnancy.

Insulin needs change dramatically during pregnancy.

Hypoglycemia is a major concern in early pregnancy.

It's never too late to improve your time in range.

Track your menstrual cycle for better diabetes management.

You are not alone in managing diabetes and pregnancy.

A supportive healthcare team is essential for a healthy pregnancy.
00:00 Introduction to Diabetes and Pregnancy Management
05:52 Preconception Planning for Women with Diabetes
08:53 The Role of Diabetes Technology in Pregnancy
11:50 Managing A1C Levels During Pregnancy
14:41 Understanding Blood Sugar Variability in Pregnancy
17:50 Automated Insulin Delivery Systems in Pregnancy
21:00 Insulin Resistance and Its Impact on Diabetes Management
23:46 Menstruation and Diabetes Management
25:58 Final Thoughts on Achieving a Healthy Pregnancy

Mentioned:
⁠⁠⁠Check us out on Instagram at our NEW IG handle: ⁠⁠⁠@sweetexpectations__⁠⁠⁠

Want to learn all there is about Diabetes & Pregnancy: ⁠⁠Your T1D Pregnancy Roadmap⁠⁠ will get your journey off to the right start.

Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠⁠Apply for 1-on-1 coaching here!⁠
51 min
September 18, 2024A Mom Gets Pre-Eclampsia and Delivers at 30 Weeks, with Kirsten Duncan, RN, T1D Mom of 1
This week's guest is Kirsten Duncan, who has lived with T1D for 15 years. She works as a pediatric nurse and diabetes educator. Kirsten experienced high blood pressure and pre-eclampsia part way through her pregnancy, which led to a 72 day NICU stay for her son. We also talk about how she navigated her relationships with healthcare providers while also being a healthcare provider. And Kirsten shares her experience and top tips getting her A1C below 6% and managing insulin resistance.
Takeaways
Kirsten Duncan has lived with type 1 diabetes since 2008.

She emphasizes the importance of preparing for pregnancy with a low A1C.

Managing blood sugar levels is crucial during pregnancy, especially with type 1 diabetes.

Kirsten faced challenges with nausea and insulin management in early pregnancy.

She highlights the significance of a supportive healthcare team during pregnancy.

Preeclampsia can occur even with well-managed diabetes, and awareness is key.

Kirsten spent 72 days in the NICU with her baby after an early delivery.

She encourages mothers to focus on their best efforts and not feel guilty about blood sugar fluctuations.

Adjusting to motherhood with diabetes requires patience and self-care.

Kirsten advises expecting mothers to enjoy the pregnancy journey despite challenges.

Chapters
00:00 Introduction and Diabetes Journey
04:06 Preparing for Pregnancy with Type 1 Diabetes
10:25 Strategies for Managing Blood Sugars During Pregnancy
17:37 The Role of the Maternal Fetal Medicine Clinic and Diabetes Educator
26:12 Introduction and Diagnosis of High Blood Pressure
26:42 Admission to the Hospital and Diagnosis of IUGR
31:29 Emergency C-Section and NICU Stay
39:24 Managing Diabetes and Motherhood
45:48 Impact of Steroid Shots and Adjusting Insulin
47:29 Words of Wisdom and Enjoying the Journey

Mentioned:
⁠Check us out on Instagram at our NEW IG handle: ⁠⁠@sweetexpectations__⁠⁠

Want to learn all there is about Diabetes & Pregnancy: ⁠Your T1D Pregnancy Roadmap⁠ will get your journey off to the right start.

Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠Apply for 1-on-1 coaching here!⁠
49 min
September 11, 2024Preparing for a Positive Pregnancy Experience with T1D, with Katherine LoPorto, T1D Mom of 1
This week's guest is Katherine LoPorto, who has lived with T1D for 30 years and is also the daughter of a T1D Dad. Katherine shares her journey from being diagnosed with type 1 diabetes at a young age to her decision to start a family. She talks about the importance of finding a supportive healthcare team and the challenges she faced with insulin resistance during pregnancy. Katherine also discusses the adjustments she made to her diabetes management and the use of multiple insulin delivery methods to manage the insulin resistance common in pregnancy. Managing diabetes during pregnancy can be challenging, but there are tools and strategies that can help! The cost of insulin and supplies can add up, but finding ways to conserve and use them effectively can ease the stress. We cover breastfeeding and the impact of postpartum hormones on pregnancy. We also discuss on the fears and worries of passing on diabetes to their children, which is a common experience for those with diabetes who are contemplating having children.
Takeaways
Being diagnosed with type 1 diabetes at a young age can become a part of one's identity and make it easier to manage the condition.

Finding a supportive healthcare team, including an endocrinologist and OB, is crucial during pregnancy with type 1 diabetes.

Managing insulin resistance during pregnancy can be challenging, and adjustments to insulin intake and delivery methods may be necessary.

Using a combination of insulin pump and injections can help manage insulin requirements during pregnancy.

Reading through care guidelines and staying informed about the latest research can provide reassurance and helpful insights during pregnancy with type 1 diabetes. Managing diabetes during pregnancy can be made easier with the use of tools and strategies.

The cost of insulin and supplies can be a financial burden, but finding ways to conserve and use them effectively can help.

Pregnancy can be easier to manage than non-pregnancy because the changes in insulin resistance are more predictable.

Postpartum hormones can be unpredictable, but overall, the experience of pregnancy and childbirth can be rewarding and empowering for women with diabetes.

The fear of passing on diabetes to their children is a common concern, but many women feel that the joy of having a child outweighs the potential challenges of managing diabetes.

Chapters
00:00 Introduction and Background
04:55 Diagnosis Story
07:33 Preparing for Pregnancy with T1D
09:57 Managing Blood Sugar Levels and Emotions
12:43 The Importance of Supportive Healthcare Providers
22:07 Insulin Dosing and Delivery During Pregnancy
23:55 Using Multiple Insulin Delivery Methods
27:19 Considerations for Insulin Resistance and Skin Irritation
33:19 The Financial Burden of Diabetes Supplies During Pregnancy
38:25 Predictable Changes in Insulin Resistance During Pregnancy
42:16 Overcoming the Fear of Passing on Diabetes to a Child

Mentioned:
With Diabetes in Mind - Katherine's blog

Check us out on Instagram at our NEW IG handle: ⁠@sweetexpectations__⁠

Want to learn all there is about Diabetes & Pregnancy: Your T1D Pregnancy Roadmap will get your journey off to the right start.

Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠Apply for 1-on-1 coaching here!
48 min
July 30, 2024Diabetes Technology & Medications During Pregnancy, with Dr. Diana Isaacs
This is a can't-miss episode! Dr. Diana Isaacs, Co-Director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, comes on the show to discuss the various nuances of using automated insulin pumps in pregnancy. She highlights the challenges of using closed loop insulin pumps in pregnancy, as they were designed for use outside of pregnancy and have higher targets. We discuss the CAM APS system, which has a lower target and more customization, but is not available in the US. We also cover the use of sleep mode on the Tandem pump and the unique algorithm that allows for tighter control, Omnipod 5 and the challenges of customization, and research on Medtronic 780G system and its lower target. We also talk about the growing use of metformin in pregnancy and the controversy surrounding it. And we can't forget GLP-1 agonists! Learn what they might mean for aiding fertility. Finally, Diana shares her expertise on how to handle the ever-changing needs of pregnancy and how to approach high blood sugars.
Takeaways
Closed loop insulin pumps are not designed for use in pregnancy and have higher targets than recommended for pregnancy.

The CAM APS system has a lower target and more customization, but is not available in the US.

Sleep mode on the Tandem pump allows for tighter control during the night.

Omnipod 5 has challenges with customization, but can still be used with adjustments to carb ratios and correction factors.

The Medtronic 780G system has a lower target and can be effective in pregnancy.

Metformin is commonly used in pregnancy, but there is controversy surrounding its use.

GLP-1 agonists are not recommended in pregnancy, but can be used before and after pregnancy with caution.

It is important to not stress over numbers and focus on the things that are in one's control during pregnancy.
Mentioned:
Diabetes Dialogues (Diana's Podcast)
Diana on Instagram: @dianamisaacs

Check us out on Instagram at our NEW IG handle: @sweetexpectations__

Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: Apply for 1-on-1 coaching here!
40 min
July 16, 2024Managing Type 2 Diabetes During Pregnancy: A Personal Journey, with Jacquean Kosh, T2D, mom of 2
In this episode, Jacquean Kosh, a licensed therapist and type 2 diabetes advocate, shares her journey of managing type 2 diabetes during pregnancy. She was diagnosed at the age of 26 and has two children. She discusses her experience with diabetes management, including going on insulin to finally get her blood sugars where they needed to be for pregnancy, and the challenges of controlling blood sugar levels. Jacquean's second pregnancy was unplanned and happened during a very stressful tim ein her life. Her A1C was over 13%, and she discusses what she did to bring it down safely. She emphasizes the importance of finding a supportive healthcare team and asking for help when needed.
Takeaways
Managing type 2 diabetes during pregnancy requires careful diabetes management and support from a healthcare team.

Insulin may be necessary for blood sugar control during pregnancy, even for individuals with type 2 diabetes.

Asking for help and building a support system is important during pregnancy and postpartum.

Focusing on what can be controlled and finding the silver lining in difficult situations can help maintain a positive mindset.
Chapters
00:00 Introduction and Diabetes Journey
04:45 Finding a Supportive Endocrinologist
07:56 Going on Insulin, Managing A1C Levels and Preparing for Pregnancy
10:13 Challenges with Hypertension
26:08 Jacquean's Birth Experiences
28:57 Managing Diabetes During Labor
31:59 Postpartum Differences
35:59 The Importance of Support
37:40 Advice for Pregnant Individuals with Diabetes

Find Jacquean Kosh on Instagram
43 min
July 02, 2024On the Cusp of 3 with T1D, with Maggie Youngblood
In this episode, I talk with Maggie Youngblood, who is in the final weeks of her 3rd pregnancy with type 1 diabetes. She shares her journey and experiences with her 3 pregnancies, including diabetes management and labor & delivery (including 3 inductions), tandem breastfeeding, and maintaining good blood sugars between pregnancies. We also talk about the impact of mental health on managing diabetes during pregnancy. Maggie emphasizes the importance of listening to her body, asking for help, and managing her emotions around blood sugar control.
Takeaways
Managing diabetes during pregnancy requires close collaboration with healthcare professionals and making adjustments to treatment methods.

Listening to your body and making smart food choices can help optimize blood sugar control during pregnancy.

Having a strong support system, including healthcare professionals, family, and friends, is crucial during pregnancy and postpartum.

Managing emotions around blood sugar control and seeking therapy can be helpful in navigating the challenges of pregnancy with diabetes.
Chapters
00:00 Maggie's Story
04:49 Preparing for Pregnancy and Managing Diabetes
10:18 Managing Diabetes in Postpartum
17:28 Comparing and Contrasting Pregnancy Experiences
32:43 Preparing for the Third Delivery
36:29 Emotional Aspects of Blood Sugar Management
Resources
Follow Maggie on Instagram ⁠@maggieryoungblood
Follow us on Instagram page, ⁠⁠⁠@yourdiabeticpregnancy⁠⁠⁠
To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠⁠⁠Your T1D Pregnancy Journey⁠⁠⁠.
Need more personalized assistance? ⁠⁠⁠Apply for diabetes coaching⁠⁠⁠ with Allison, a certified diabetes educator and T1D mom.
44 min
June 19, 2024Pregnancy with MODY Diabetes, with Kylie Kulwicki
Although we are most familiar with type 1 and type 2 diabetes as being the dominant pre-existing diabetes in pregnancy, there is also MODY, Maturity Onset Diabetes of the Young (MODY), a rare form of diabetes caused by a gene mutation. In this episode, we chat with Kylie Kulwicki, who shares her experience living with MODY and how she managed her type of diabetes during pregnancy. MODY is caused by a gene mutation, and there is a 50% chance that her children will also have MODY. She discusses how she and her husband approached this risk in the episode. She also discusses the challenges of insulin resistance, the importance of pre-bolusing, and the anxiety of managing blood sugar levels.
Takeaways
Maturity Onset Diabetes of the Young (MODY) is a rare form of diabetes caused by a gene mutation.

Having a child with a 50% chance of inheriting MODY can be a source of anxiety, but being prepared and having knowledge about diabetes can help manage the situation.

Managing blood sugar levels during pregnancy with MODY requires careful monitoring and adjustments to insulin doses.

Pre-bolusing and setting lower blood sugar ranges can help manage blood sugar levels during pregnancy.

Induction of labor is often recommended for people with diabetes to reduce the risk of stillbirth.

Breastfeeding can affect insulin needs, and it's important to be prepared for potential lows and adjust insulin doses accordingly.

00:00 Diagnosis with MODY
04:50 Managing Blood Sugar Levels During Pregnancy
13:02 Insulin and the Pregnancy Experience
16:01 Coping with Anxiety and High Blood Sugar
29:11 Managing Diabetes Postpartum
33:13 Breastfeeding and Future Children
Resources
Follow Kylie on Instagram @mylifewithmody
Follow us on Instagram page, ⁠⁠@yourdiabeticpregnancy⁠⁠
To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠⁠Your T1D Pregnancy Journey⁠⁠.
Need more personalized assistance? ⁠⁠Apply for diabetes coaching⁠⁠ with Allison, a certified diabetes educator and T1D mom.

Disclaimer: Nothing you hear on the Sweet Expectations podcast should be a substitute for personalized professional medical or mental health advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan.
35 min
June 12, 2024Tips for Lowering Your A1C, with Ginger Vieira, T1D mom of 2
Ginger Vieira, author of 'Pregnancy with Type 1 Diabetes', mom of 2 and 25-year veteran of T1D, shares her experience and advice on managing diabetes during pregnancy. She emphasizes the importance of being intentional with insulin doses and being mindful about overtreating low blood sugars. She encourages women to focus on what they can control and not strive for perfection. Ginger is the co-author of Pregnancy with Type 1 Diabetes, and a new book, How to Stop Overtreating Low Blood Sugars.
Takeaways
Be intentional with insulin doses and make careful choices around food

Focus on what you can control and prioritize getting the right amount of insulin

Adjust basal insulin and be consistent with blood sugar management

Insulin needs will increase during pregnancy, and that's normal and necessary for a healthy pregnancy
00:00 Introduction and Background
05:04 The Importance of Diabetes and Pregnancy Resources
09:42 Preconception Planning and Blood Sugar Targets
14:27 Changing the Definition of 'High' Blood Sugar
23:08 The Differences Between Injections vs. Pumping
28:42 Treating Lows Effectively
31:01 Don't Be Afraid to Increase Insulin
35:50 Encouragement for Women Considering Pregnancy
40 min
June 04, 2024Optimizing Management Strategies for Pregnancy, with Jenny Smith, RD, CDCES
In this episode of Sweet Expectations, I interview Jenny Smith, a registered dietitian, Certified Diabetes Care & Education Specialist and a mom with type 1 diabetes. We discuss the importance of preconception planning, including optimizing glucose management by becoming more skilled in using the tools and strategies available. We discuss the benefits of continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems in managing blood sugar levels during pregnancy, as well as utilizing multiple daily injections. Insulin resistance is a common challenge for women with diabetes during pregnancy due to hormones have a significant impact on glucose and insulin levels. Insulin resistance can start in the early days of pregnancy and gradually increases throughout the second and third trimesters. We discuss ways to manage insulin resistance, including adjusting insulin doses, pre-bolusing, using alternative insulins like U-200 and considering medications like metformin.
Takeaways
Preconception planning is crucial for managing diabetes during pregnancy, including optimizing glucose management, setting targets, and ensuring quality nutrition.

Continuous glucose monitors (CGMs) provide valuable visibility into blood sugar levels and help make more informed decisions about insulin dosing.

Automated insulin delivery (AID) systems can be beneficial in managing blood sugar levels during pregnancy, but individualization and close monitoring are necessary.

Personalized care and individualized recommendations are essential throughout the pregnancy journey to ensure optimal health for both the mother and baby. Pregnancy hormones have a significant impact on glucose and insulin levels, leading to insulin resistance.

Insulin resistance typically starts in the early days of pregnancy and gradually increases throughout the second and third trimesters.

Managing insulin resistance involves adjusting insulin doses, pre-bolusing, and considering medications like metformin.

Delivery timing for women with diabetes varies depending on individual circumstances and hospital protocols. Open discussions with healthcare providers are important to determine the best plan for a safe and healthy delivery.
00:00 Introduction and Pregnancy Journey
05:55 Preconception Planning and Assembling a Supportive Care Team
29:17 Managing Insulin Resistance with Technology
37:41 Medications and Strategies for Insulin Resistance
42:53 Timing of Delivery and Individualized Plans
49:50 Open Communication and Setting Realistic Birth Preferences
More from Jenny:
Integrated Diabetes Services
Pregnancy with Type 1 Diabetes
Resources
Follow us on Instagram page, ⁠@yourdiabeticpregnancy⁠
To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠Your T1D Pregnancy Journey⁠.
Need more personalized assistance? ⁠Apply for diabetes coaching⁠ with Allison, a certified diabetes educator and T1D mom.
Disclaimer: Nothing you hear on the Sweet Expectations podcast should be a substitute for personalized professional medical or mental health advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan.
54 min

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Navigating the highs and lows of a pregnancy with pre-existing diabetes.

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Sweet Expectations

Sweet Expectations episodes

About Sweet Expectations